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Effective Risk Management in
Healthcare Practice Dr.Abdul Qawi Almohamadi
TQM-Manager USTH
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Healthcare
System made up of thousands of inter-linked processes……………..
things can go wrong
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What is risk?
Clinical Risk Non Clinical
Risk Financial Risk Organizational
Risk Significant Risk
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Definition of risk management
Risk is generally defined as the potential harm that may arise from some present process or from some future event.
In everyday usage, "risk" is often used synonymously with "probability", but in healthcare risk assessments, stricter parameters must apply due to the nature of the risks to life and health involved.
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Definition of risk management
Risk Management is the process of measuring, or assessing risks and then developing strategies to manage the risk.
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Definition of risk management
Planned and systematic processes to reduce and/or eliminate the probability of losses occurring in a specific setting:
risk identification and analysis
loss control claims management and risk
financing
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Definition of risk management-summary
1- To identify the hazards rising from work
activities that employees and other people are exposed to.
To decide on the likelihood of harm or
damage occurring to people, equipment or property from those hazard.
To determine what action needs to be
taken to control adequately the risks identified.
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Why risk management 1/3?
Risk Management employs a number of systems to identify and provide notification of incidents or events that have occurred involving patients, visitors, staff, equipment, facilities or grounds which are likely to give rise to potential liability, affect the quality of patient care or affect safety in the hospital.
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Why risk management 2/3?
The early identification of such occurrences allows to immediately investigate the circumstances of the incident, and if necessary, institute corrective action to prevent similar occurrences in the future.
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Why risk management 3/3?
To have clearly defined roles and responsibilities for the management of risk.
To improve patient safety through the adoption of a coordinated and multidisciplinary approach to the management of risk.
To encourage open and honest reporting of incidents through the use of a single incident reporting system.
To establish clear and effective communication that enables information sharing.
To foster an open culture that allows organization wide learning.
To ensure that risks are identified, assessed and prioritized for action
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Categories of Risk Patient care-related
risks Medical staff-related
risks Employee-related risks Property-related risks Organizational risks Financial risks Other risks
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Patient Care-related Risks
Risk associated with clinical practice – direct patient care and incident reduction.
Indirect patients care – security, personal, infection control, management of buildings and the environment.
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Patient Care-related Risks Direct association with patient care Consequences of inappropriate or
incorrectly performed medical treatments Confidentiality and appropriate release of
information Protection from abuse, neglect and assault Was patient informed of risks? Nondiscriminatory treatment
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Exercise Patient flow in the hospital
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Admission Office
Emergency Room
Outside Clinics
Discharge
Transfer to another facility
Admission
Admission
Special care units
General floors
Endoscopy
OR
Cath. Lab.
Radiology
Patients Flow
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Medical Staff-related Risks
Was patient properly managed?
Do we have adequately trained staff?
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Medical Staff-related Risks
Occupational safety and health, - working practice, legislative requirements, training and education.
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Exercise Medication management cycle
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Medication Management Process
Physician write the medication order
Medication prepared by pharmacy
Registered Nurse prepare medication
Porter send the order to the pharmacy
Porter send the medication to the nursing unit
1. illegibility2. Use of
abbreviations3. Incomplete orders
Registered Nurse transcribe the
medication order
1. Wrong transcription
Delay
Delay
Registered Nurse administer medication
to the patient
1. Patient identification
2. Wrong medication3. Wrong time4. Wrong dose 5. Wrong route
Miss labelMiss label
Delay
Miss label
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Employee-related Risks
Maintaining a safe environment - Employee Health Policyreducing risk of occupational
illness and injuryproviding for the treatment and
compensation of workers for work-related illnesses or injuries
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Employee-related Risks Provide a healthy atmosphere for
workers Promote increase work production
by improving the health of the worker
Promote safety against health hazards encountered in the work environment
Promote full functional capacity of the worker
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Property-related Risks Protect assets from losses due to
fires, floods, etc. Paper and/or electronic records -
patient, business and financial - protected from damage or destruction
Bonding and insurance to protect facility from losses
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Organizational risks
Organizational risks – claims management, communication and information technology development.
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Quality in Healthcare
Begins with ensuring patient safety
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Key reasonsPatients are more at risk
than non-patientsMedical interventions are,
by their nature, high-risk procedures - small error margins
Medicine remains an inexact, hands-on endeavour
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Errors are inevitable
………….but most are preventable
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Risk Management is Everyone’s
Responsibility!
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The steps in risk management
Carrying out a risk assessment comprises of the following 5 steps:
STEP 1: Look for the hazards. STEP 2: Decide who might be harmed. STEP 3: Evaluate the risks and decide
whether the existing precautions are adequate or whether more should be done
STEP 4: Record your findings. STEP 5: Review your assessment and
revise it if necessary.
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HOW TO IDENTIFY RISK ?
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Risk Identification & Analysis
Risk RankingSignificant RisksUnacceptable RisksAcceptable Risks
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Risk Analysis
Once identified, risks will be analyzed using the risk grading matrix – risk
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ConclusionIntegrated and coordinated
approachAccountability by leadershipEnvironment
encourage recognition & acknowledge risk
actions to reduce riskfocus on process and systemsorganizational learning
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ALWAYS REMEMBER Risk Management is not about
pointing blame but about promoting a culture that fosters learning and improvement as a result of errors.
Everyone has a right under the law to an environment that is as risk free as possible.
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